Anesthetic

     Anesthetics are necessary for surgical operations, and it is hardly imaginable to have an operation without anesthesia. In the early 19th century there were no reliable anesthetic agents in Europe, and Napoleon's surgeon was said to have to rely on swiftness to reduce the pain of wounded soldiers. He was said to have performed amputations on more than 100 wounded soldiers within one night.

    In China, in as early as the Warring States Period, Bian Que, a famous physician and surgeon of the time, had concocted an anesthetic "toxic wine" to be used in surgical operations. In the 3rd century Hua Tuo (?-208) invented an anesthetic to be used in general anesthesia for a patient to have an operation in the abdomen.

    Hua Tuo, a celebrated physician and surgeon of the Eastern Han Dynasty, had practiced medicine in the provinces of Anhui, Jiangsu, Shandong and Henan. When drugs and acupuncture failed to cure illness in the internal organs, Hua Tuo would perform operations on patients. Before the operation, he would ask the patient to take the anesthetic with wine. When the patient lost consciousness, Hua Tuo would open the chest or abdomen to treat the affected organ and then apply a magic ointment on it, and the patient would recover within four or five days.

    Legend has it that before his invention of anesthetic Hua Tuo had performed an unconventional operation on Guan Yu (?-220), a heroic general of the Shu state. During a battle General Guan was shot in the arm and the arrow that hit him proved to be a poisoned one. The poison quickly spread to the bone, and Guan's men sent for Hua Tuo immediately. After examining the wound, Hua told Guan that it was too late for any drug or acupuncture to work, and the only way to save him was to cut open the wound and remove the poison from the bone. Without any hesitation Guan stretched out his arm for Hua, and kept playing chess with another person. Guan remained calm, talking and laughing, while Hua used a knife to scratch the poison from the bone. Knowing that ordinary people would never be able to endure such great pain, Hua worked even harder on his invention and finally made it.

    Then Cao Cao (155-220), a great strategist who ruled northern China at that time, had a severe headache, and he sent for Hua Tuo. Hua examined Cao and told him that he should take anesthetic first and then be operated on to remove the focus from his head. An oversensitive Cao suspected that Hua intended to kill him by applying the anesthetic, and he executed Hua in cold blood. Hua's anesthetic was thus lost.

    According to the History of the Later Han Dynasty, Hua used his anesthetic in surgical operations of removing part of the intestines, caesarean births, and excising tumors. Even today such operations are not minor ones. Hua's anesthetic technique had a great influence on later medical practitioners. In the Song, Yuan, Ming and Qing dynasties, Chinese doctors developed agents for local anesthesia, but they failed to find out the formula of Hua's anesthetic. The only known element was stramonium, which causes loss of sensation.

    More than a century ago, a Japanese doctor claimed that he had found the formula of Hua's anesthetic, which included stramonium, chuanxiong rhizome, aconite, and arisaema tuber. However, of the two persons on whom the formula was tested, one was killed and the other blinded. It seems Hua's formula would remain forever a secret.

    In the West, American dentist Horace Wells was the first to use laughing gas (nitrous oxide) as an anesthetic in 1844, but the result was not satisfactory. In 1846 William Morton, another American dentist, publicly demonstrated the use of ethyl ether as a general anesthetic during surgery.